Is it okay to lie to someone with dementia?

Advice

A person with dementia might ask questions that are difficult to answer truthfully without causing distress. Read our advice on why the person might be asking these questions and how to respond in situations where it might be better to lie or to not tell the whole truth.

Tim Beanland and Angelo Makri
02 February 2024
long read

I try not to lie, honestly, but some things push the boundaries: “Socks! You shouldn’t have”; “Oh, I thought you meant I should eat the entire cake” and – often to my subsequent regret – “No, I'd love to have your mother visit”.

Being a bit flexible with the truth is just part of the social contract, it seems - the price we pay for jogging along in relative peace. But what if one of us has dementia? What price comes with telling the truth then?

Types of questions a person with dementia might ask

The questions people living with dementia ask can challenge us. You may recognise some of these from your own experience:

  • When is dad coming to visit? (When the person’s father is sadly long dead)
  • Will I be going home soon? (Person living in a nursing home)
  • Shall I set the table for the guests? (From a former B&B owner, now in residential care)
  • You seem nice... but who are you? (Person to their partner)
  • Who are those little people by the window? (Person could be living anywhere)

For those close to people with dementia, how to respond to their questions can be a daily challenge. Is it acceptable to lie – ever? Or should we just tell the brutal truth - always?

How we respond will affect how the person and us feel and behave, now and in the future. We feel that if we get things ‘wrong’ we might damage a relationship that may well be already strained. 

Why might a person with dementia ask difficult questions?

Difficult questions often arise when the person is living in a different reality and/or has different beliefs from those around them.

These differences may become more apparent as dementia progresses but they are not limited to the condition’s later stages. They include:

  • behaving as a younger version of themselves (time-shifted)
  • beliefs – sometimes strongly held – that are false to others (delusions)
  • unfounded suspicions or allegations about others (infidelity, malice, deceit)
  • experiencing things that aren’t there (visual hallucinations).

We need to understand that these realities and beliefs often have meaning for the person with dementia, and we should not belittle or dismiss them.

Rather, as with changes in behaviour, the challenge when supporting someone is to get behind the words, rather than attribute them as simply dementia ‘symptoms’.  (Hallucinations in dementia with Lewy bodies may be an exception because they can be a symptom.)

For example, if someone with dementia asks for their dad, they may be expressing a need for comfort which is not being met.

If someone says they are setting the table for 'guests', maybe it's because they are looking for something to do, or are using older, more familiar memories to make sense of the present. When someone with dementia invents a story, it may be a coping strategy to support self-esteem.

When someone with dementia unknowingly invents a story – which is called confabulation – it may be a coping strategy to make sense of the world around them.

Should you always tell the truth to a person with dementia?

Is it important to recognise that 'truth' and 'lies' are not always simple or clear cut.

A spectrum runs from ‘whole-truth telling’ through ‘looking for alternative meaning’, to ‘distracting’, ‘going along with’ and finally ‘lying’.

As we move through this sequence the level of deception rises and we feel less at ease; who likes lying to a loved one?

It feels uncontroversial that we would all want our default response setting to be telling the whole truth. But it is equally obvious that the whole truth can sometimes be brutal or cause pain or discomfort. Who would support telling the whole truth when a person repeatedly asks after a long-dead parent as if the parent were still alive?

The whole truth here could mean repeatedly breaking the news of the parent’s death as if it has just happened, over and over again. What could be more cruel?

Selecting the correct response to reduce distress

We instinctively want to lean towards the ‘whole truth' end of the spectrum, but we also want to minimise any distress our response causes to the person with dementia.

But these aims often contradict, leaving us to seek a balancing act or a ‘least-bad’ trade-off. (We should not forget our own wellbeing either, as we don’t want to end up feeling bad about ourselves.)

One consequence of this approach is that we tell a direct lie only when doing anything else would cause the person significant physical or psychological harm. Professionals sometimes call this a ‘therapeutic lie’, but it needs to be seen a bit like antipsychotic drugs: used only under very select conditions and even then only with extreme care.

It’s also really important to recognise how hard this balancing act can be, and how impossible it can sometimes feel.  This is true particularly if the person’s realities/beliefs fluctuate – for example, if they are time-shifted only some of the time.

Carers can often find themselves being unfairly accused or argued with, find that their own reality is being suppressed, or feel unnecessarily guilty if they occasionally get their response ‘wrong’.

Responding to difficult questions from a person with dementia

Although every case needs taking individually, some guiding principles to start with include:

  • be compassionate 
  • try to understand and acknowledge the person’s feelings
  • seek to reduce distress and promote wellbeing or happiness.

When a person with dementia thinks you have stolen from them

Let’s take an example of a person who believes you stole their purse, on the assumption that the person’s suspicion is unfounded and they’ve simply mislaid it and forgotten where it is.

Perhaps this has happened before and when you found the lost purse you returned it with a whole truth: ‘I didn’t steal it; I found it in a drawer where you put it’. 

If this approach has caused an argument or distress, it may be better to try something less blunt next time: ‘It looks like it wasn’t stolen after all, it was just hiding upstairs’. If it’s a common accusation, trial-and-error can be useful in finding a suitable approach.

When a person with dementia asks about a deceased love one

If you think the person needs comfort or assurance, then ‘Is there something you wanted to speak with them about?’ might work.

The person with dementia may just want to reminisce about the person, and you could try saying something like, ‘I can tell you really cared for each other – tell me about them’, perhaps reinforced with personal photos, letters, or objects.

Or it may be that the person with dementia is still grieving, in which case gently acknowledging that their partner has died and supporting them to grieve might be best – for example by talking about their relationship and the person’s life.

As is so often the case for a person with dementia, feeling heard may be more important than being given advice.

But if the question here is frequent and the grief severe, then the kindest response is likely to be to acknowledge the person’s feelings and gently move them on to a topic or activity that you know they will enjoy. This is clearly ‘distraction’ but it should still not deny or ignore their feelings.

This article was first published in 2019 and most recently updated in February 2024.

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93 comments

Kate
says
03 May 2023 at 10:04 am
My Mum has been in a Care Home for the last month. It is one of the best and the ladies that look after her are amazing. She does like the home and the people in it too. However, she does want to go home. She doesn't remember the apartment she was in for the last 9 years just the house she was born in. I let her know that she will not be going back there and talk about her apartment and that there is work being done on the bathroom. I have not told her she will not be going back. She also misses her little dog, I am looking after him and take him to see her as many times as I can but she wants to keep him there. She does not care for him properly so cannot have him at the home. I am having a really hard time coping with the loving lies I am telling, I have started Wellbeing Counselling in order to get over my guilt. My counsellor gave me some great advice and it is really helping. It is one of the hardest things I have ever done in my life to put my mum into a care home. She always said she never wanted to go into one but we also know that she would have never wished for Alzheimer's too. I wanted to join a group for other people in my situation but could not find any either.
Paul Button
says
14 January 2023 at 10:12 am
What about when the same question is asked repeatedly every 30 seconds or couple of minutes or will ask somebody else the same question as if they don’t believe you or are playing you off between each other like my mother who has an unspecified dementia does with me and my father. We have a policy of being true full In a gentle way
Mrs PK
says
11 January 2023 at 12:10 pm
Cutlery ! I dread that word ! My mother bought some white plastic handled cutlery back in the 80s or so, and over the years the plastic broke, and the metal part of the knife fork or spoon thrown away or relegated to the shed . But since My Dad died, Mum noticed, as if for the first time , there were only some of the set left, and began suspecting the Carers of stealing it. There is some reason for her thinking this , because when she was a child back in the 30s in a very poor area of Lancashire and they had a maid in to help , the maids occasionally stole items . My Grandmother turned a blind eye because she knew the maids were so poor . However the whole thing has escalated over the last 2 or 3 years when Mum started hiding cutlery . First she hid her "best" set , and gradually not only other cutlery , but all kitchen tools : wooden spoons, sharp knives, whisks etc so that it became impossible to prepare a meal when i went over to visit. I did try buying a cheap set of cutlery and leaving it in the drawer with large labels saying "This is Pat`s" cutlery please return to this drawer after use " but that got hidden away too. These days I have a bag of basic cutlery and kitchen tools which i take with me over on visits , and grit my teeth when my lovely Mum says " but what are we going to do for cutlery - the maids/those women/those theives have stolen it all right under my nose " etc . I also have to be quick to make sure she doesn`t wash mine up and hide it away ! I have spent so many hours searching her house for things of more importance that she has lost or hidden, like glasses or hearing aids, but she has got steadily cleverer at hiding things and i find searching increasingly irritating . I have only a limited amount of time there, to do her shopping and count out her medication ,because of the distance she lives away from me, and i can`t drive in the dark . When i recount some of the things she gets up to, people who haven`t direct experience of dementia tend to laugh , ( tin openers in the wardrobe/airing cupboard) and indeed i do eventually see that it`s funny, but at the time i see red, and that`s the hardest thing i think, i have learned that there is absolutely no point in explaining what has happened to the (damned) cutlery or saying anything reasonable like " Nobody wants your old cutlery - it`s so cheap nowadays " her brain can`t reason things out any more . But i haven`t worked out what is the best thing to say because occasionally she challenges me to ring the Carers and complain , in which case , i have suggested she do so. I have spoken to them and they understand, and with good humour, but i have no idea how they respond to her accusations. Maybe they have some way of calming her down with a little fib . So far all i can do is try and change the subject , i can`t avoid eating there even though to her it is problematic, now that she has "only" one knife fork desert spoon and a coffee spoon "left" in the drawer! I cannot think of a lie that would appease Mum as to the whereabouts of the missing cutlery . And really i suppose there could be far worse things she does !
Veronica Ashby
says
24 February 2023 at 9:25 pm
Thank you for such insight into the cutlery issue and your mum. It must be so difficult to deal with this when you are obviously a very busy person and of course you have the limitations of quite simply being a human It just occurred to me that you might get involved in your mother's struggle to safeguard her cutlery etc. and plot with her ways to keep it safe from the thieving hands of others. Only you and she would be able to access the items that are so important to her.
Moussa Haddad
says
11 January 2023 at 7:42 am
Really thought-provoking article. One thing I'd like to add into the mix is diet: at Vegetarian for Life, we've come across numerous examples of vegans or vegetarians with dementia being fed meat. That could be because the care setting encourages it due to a belief that people need meat in their diet; it could be because, in their confusion, the resident is asking to have what everyone else is having; or it could be because they at that moment appear to have forgotten that they a vegan/vegetarian, even though that's been a fundamental part of their identity for decades. There aren't always easy answers in that situation, but we have been signing care establishments up to a Memory Care Pledge that focuses on engaging with the individual, providing them with options, and in cases of issues with capacity or cognition, offering vegetarian/vegan dishes in place of meat ones where the latter have been requested, on the basis that this is more suited to the resident's deeply-held philosophical beliefs and values. We've had a pretty good response so far from the care sector. (See: https://vegetarianforlife.org.uk/pages/pledge)
Alzheimer's Society
says
12 January 2023 at 4:28 pm

Thanks for your comment, Moussa. We agree that respecting people’s values about food and drink is really important. 


You may want to read about our ‘This is me’ leaflet, which can be used by people living with dementia, and their carers, to record details such as cultural and family background, dietary requirements and preferences. This can be used in any setting, for example in hospitals and care homes, to help health professionals deliver care that is tailored to people’s needs.

 
You can download our ‘This is me’ leaflet online, or order a copy by post: https://www.alzheimers.org.uk/get-support/publications-factsheets/this-is-me

 

Thank you

Alzheimer’s Society blog team

Anna
says
17 January 2023 at 4:29 pm
Hi Moussa - this is a great point, as a person with a restricted diet due to beliefs I would be devastated to think I could be being fed something else if I developed dementia. I think an important part of this is the fact that, whilst in the immediate short term, feeding someone something they ask for seems like the best option, what happens when they have a lucid moment and realise that they have been eating meat (or otherwise) when they have really strong beliefs against it? That would be gut-wrenching for me. Really glad to hear about your work!
Peter Clark
says
10 January 2023 at 4:52 pm
As a PWD I'm confused enough as it is without people lying to me. We struggle to make sense of what sense of what's going on around us as it is without being fed self serving nonsense, if you do not know what use is going to be made of the lie then it would be better to say nothing or just try distraction.
Liz
says
29 April 2022 at 12:57 pm

I work in care homes and my question is around the care plans. I am in favour of 'little white lies/avoiding the truth' where necessary to avoid distress, but my role involves care plan writing and I believe it is better to be up front and state how we would manage situations and information in care plans can enable staff to respond consistently, however I just KNOW that to be totally open and put in writing how we manage situations will draw criticism. Also, we have to read through care plans with residents and their families, so the 'white lies' would be available for the resident to see. I guess the same would apply to covert medication for example. I know we have to gain authorisation from a GP and complete an MCA/Best Interest Decision, etc. but again when residents are encouraged to view their care plans, the 'deception' albeit with good intentions and out of necessity, is exposed. I would be very interested to get other people's thoughts as I struggle to get direct answers from senior colleagues/external agencies who seem reluctant to commit to a response .

Theresa Singh
says
16 November 2021 at 9:10 pm

Hi, I'm really struggling with what to say to my husband when he asks about his sister who passed away more than 10 years ago. I struggle because he asks me directly "is she alive".
A closed question that leave me no 'wriggle room' to respond. He is usually looking upset when he asks and I think that he knows the answer but can't make sense of it.
I cant keep confirming that she's passed away as his grief is so intense and lasts for hours.
He is asking at least once a week.
I just need help to formulate a standard and believable response. I'm finding that I am starting to get anxious anticipating this situation occurring again.
Thank you for your suggestions /advice

Patti Hall
says
04 February 2022 at 4:10 am

I’m a psych nurse with years of experience working with geriatric patients who have dementia. I have seen the heart wrenching grief patients experience when told the truth—it’s cruel and unnecessary. If told the factual truth they relieve the extreme, intense sadness they felt when they first learned of their loved one’s death. When they ask tomorrow or next week it will happen again—and again and again.

From childhood we are taught not to lie, and most religions teach that lying is a sin. But, deliberately hurting another is also wrong and sinful—and is a greater sin than lying. No matter how many times you tell a person who has later stages of dementia they will not remember what you said. If they do occasionally remember that their spouse or mother died it would be in the context of ‘years ago.’)

If you’re really torn about their need to know, you might say, “Yes, mom is alive in our hearts” or, “I haven’t seen mom this week, either.” But, these evasive responses don’t typically work, they just provoke more confusion and questions.

My response when my dad asked these questions was, “Your mom just went to visit the neighbor.” (or something similar). My rationale was it was probably technically true; they both died years ago, so grandma did join her friend. My grandmother was always visiting her neighbor so it was believable, and my dad very much believed in heaven—where I imagine grandma and Millie were both playing cards, joking and laughing—as they always did.

Joseph John Teeling
says
10 January 2023 at 10:12 pm
In a case like this I feel because of the memory loss, each time you tell the truth he reacts as if he is grieving for the first time again and again so perhaps a "white lie" to ease or distract would be more humane
Joyce Brackenridge
says
11 January 2023 at 3:34 pm
My hubby passed there 14 November and he always asked about his sister ,mum and brother they had Alzimmers as well ,and I always said they were always away working or on holiday and hard to keep up with, and his reply was oh your right there. we all went with the flow and he was alright with that ,to me we did the right as they go back a long way so why change what they don’t know .
Julie
says
16 July 2021 at 2:32 pm

My mum was diagnosed with Alzheimer’s vascular dementia last year which was initially put down to grief / depression following the sudden loss of my Dad in Aug 2019 after 54 years of marriage. Dad had prostrate cancer and mum had cared for him for 4 years.
I care for my mum alone with my husband and 2,teenage boys - my sister doesn’t live local so the majority of care is on my shoulders. I enjoy looking after mum and have changed my job to part time to be around more for her. I am currently considering anther career change to a caregiver so it will allow be the flexibility to take mum to her memory classes and COGS groups but my husband is worried this will be too much fit me - he feels I am making too many changes for mum and too much pressure on my shoulders.
Can anyone advise ?

Alzheimer's Society
says
19 July 2021 at 10:20 am

Hi Julie,

We're sorry to hear about your mum. It sounds like you're in a difficult position on whether to take on more caring responsibilities.

We'd recommend discussing this with one of our expert dementia advisers, who can listen to you, talk through your situation, and provide specific advice and guidance. You can call our Dementia Connect support line on 0333 150 3456. (More details, including opening hours, are available here: https://www.alzheimers.org.uk/dementia-connect-support-line)

You might also like to join our online community, Talking Point, where carers and other people affected by dementia can share their experiences and receive peer support. This could be a great place for you to get help and advice from other people who have been in similar situations: https://www.alzheimers.org.uk/get-support/dementia-talking-point-our-on…

In the meantime, you may want to read our booklet, 'Caring for a person with dementia: A practical guide', which you can view online, download, or order by post: https://www.alzheimers.org.uk/get-support/publications-factsheets/carin…

We hope this helps, Julie. Please talk to one of our dementia advisers if you need advice.

Alzheimer's Society blog team

Linda
says
20 January 2021 at 4:01 am

IS IT RIGHT OR WRONG TO LIE TO PATIENTS WITH DEMENTIA?

I dealt daily with my Mom’s dementia for 7 years. There is no exact answer for “lying or not” with a dementia patient!!! There were times I told my mother the truth because I sensed knowing would ease her anxiety or anger. She was furious with my Dad and complained bitterly one day about his lack of consideration for going out and not telling her or leaving a note. (My Dad had been dead for 12 years at that point). When I told her Daddy was dead and we talked about him and I assured her that her husband would be right here with her if he were alive. She was comforted and calmed. There were other occasions, when I was out of town, and I would speak to her in the evening. She expressed loneliness and anxiety. It did no good to remind her that I had just been with her the day before because she could not remember. HER ANXIETY WAS RIGHT THEN. I would lie and say ,” I will see you in the morning “, even when I knew it would be three days before I could be with her. Keeping her calm and reassured was THE MOST IMPORTANT THING. I lied frequently when it was what would comfort her or calm her or keep her safe. I NEVER argued with her when she was wrong because it would have been as reasonable as arguing with a cocker spaniel.
My Mom lived her last years for the most part happy, or at least content. She did not have the problematic episodes of depression or combativeness or wandering; which is so common to Alzheimer’s patients. I AM CONVINCED IT IS BECAUSE I ADAPTED TO HER WORLD instead of trying to keep her in the “real” world - that was totally beyond her comprehension. I validated her worries and focused consistently on reassuring her that everything was OK. If she said,”I can’t remember”- I would say, “ It is okay, I remember and will tell you what you want to know”. Even if it meant I repeated A LOT! . I will not be convinced it was wrong and her gerontologist told me my Mom was a pleasure because, she was happy- a rarity in his practice.

Denzil
says
15 September 2021 at 5:25 am

Hi Linda my mum is in her early stages of this, and I am so grateful for your post and for the practical point of view and suggestions that have worked so well for you. Thank you - I am optimistic that my mum's personality will be able to sustain us all, in the days ahead, when I'm going to have to return to your wisdom often, I fear. Optimism is certainly what I need right now.

Bonnita spencer
says
11 January 2023 at 11:29 am
I think you did an amazing job of caring for your mum. I try to do the same with my wonderful step dad.
J
says
30 January 2023 at 1:51 am
Thank you for this helpful and encouraging post Linda. Helping my loved one feel loved and supported has so far also proven the most beneficial. Your toolbox example, ‘It’s okay, I remember and will tell you what you want to know”, is reassuring, calming and supportive. Adapting to their world is also the most enjoyable for both of us. We engage more calmly, we laugh and smile more and communication exchanges slow down, which gives us both more time to respond in a kinder way. Thanks again,
Veronica Ashby
says
24 February 2023 at 9:37 pm
Hello Linda, The most important thing we can do with anyone who is struggling to come to terms with a life that makes no sense is to enable them to find some inner peace. I am overwhelmed by the message you transmitted to us on how to do just that. Your Mum was so lucky to have you.
Bridget Bicheno
says
18 September 2020 at 9:32 am

I have visited a lady with dementia recently with her son, he wanted me to go in 3 times a week. It didn't go well and she wss angry with her son for suggesting it. Now I'm visiting with hef daughter while she is staying with her mother. Her daughger asked me to say I am her friend, but what if her mother femembers me and asks if I have been before?

21 September 2020 at 12:44 pm

Hi Bridget,

Thanks for getting in touch. It sounds like you're in a difficult situation.

We'd recommend discussing it with one of our expert dementia advisers, who can talk it through and provide advice and guidance. You can call our Dementia Connect support line on 0333 150 3456. (More details, including opening hours, are available here: https://www.alzheimers.org.uk/dementia-connect-support-line)

We also have an online community, Talking Point, where carers and other people affected by dementia can share their experiences and receive peer support: https://www.alzheimers.org.uk/get-support/dementia-talking-point-our-on…

We hope this helps
Alzheimer's Society blog team

Nicola
says
20 July 2020 at 9:10 am

My dad has been diagnosed with vascular dementia and Alzheimer’s two and a half years ago. I’m that time he has mainly remained steady but lockdown has been hard for him. He listened to the radio every day and heard constant ads to stay in and stay safe and wouldn’t go out or open his windows. Prior to that I had been told by his on/off partner and some friends that he wasn’t washing himself or his clothes as well. He’s still in denial he has the condition and won’t accept help. As soon as we were able to we bought him to our house To join our bubble which he has been to numerous times over the years so knows our house well. There was lots I noticed apart from the clothes issue - he packed mainly dirty clothes, had 3 dosset packs of tablets he asked the same questions many times and in much quicker succession than I had seen before. I noticed definable good and bad days. Then the biggy he admitted to forgetting important things his address, where he is going? And how to open his front door. I then rushed around making phone calls to try and get him help and support and when they spoke to my dad he refused all of it. I was so angry with him even though I called him and we had an argument about it. I feel totally helpless that I know he needs more support in certain areas and because he said he’s fine and he’s fed up of people telling him what he should be doing he won’t get it. After that when I was due to visit him he called on the morning of it and told me he was ill and not to come down. This is not the first time it has happened and is always after I have called him out.

20 July 2020 at 1:44 pm

Hi Nicola,

Thanks for getting in touch. I'm sorry to hear that you and your dad have been having a difficult time.

It sounds like you could do with some support, so please call our Dementia Connect support line on 0333 150 3456 or email us at [email protected]. One of our trained dementia advisers will be able to learn a bit more about your situation and give some ideas, advice and support.

Hope this helps, Nicola.

Alzheimer's Society blog team

Bonnita spencer
says
11 January 2023 at 11:36 am
Its very difficult for you and what you are experiencing buts its also very difficult for him and if you are arguing about it he will losetrust and faith in you...try a softer approach, l know easier said than done but if you sit quietly and dont point out his faults but instead what he is doing well...this will make you feel better and him more in control of his life. I understand...truly🇬🇧🇬🇧
Peter Tomkins
says
15 February 2020 at 11:13 am

With my wife I quickly realised that when told her Mother and Sister were long dead it was not the fact that they were dead that upset her but the fact that she had forgotten it.

RWD
says
13 January 2023 at 2:46 am
Yes! That happens to my mum as well that has Alzheimer! My dad gets confused instead (he's got vascular dementia ) when he realises he's said something that is not right or that he had forgotten about. Poor thing! That breaks more my heart that my mum having a fit! (She always had a short fuse anyway without dementia...) But bottom line it is a difficult thing to make a decision: to lie or not to lie.
Alan
says
13 February 2020 at 12:14 pm

I had a partner, now passed, who quite frequently saw other non-existing persons in the room or outside in the garden. Sometimes she said these were her relations. At first I said I didn't think there was anyone there. These delusions did not seem to worry or threaten her, so I changed to saying they were there to see she was alright, or similar. Seemed to work. Might help someone..

SANDRA-LEE
says
28 January 2020 at 8:32 pm

I care for a lady with dementia for the last 3.5 years. She seems to go through a cycle of violence similar to an abusive partner would. After she strikes out she calms down significantly. I was wondering if anyone else experiences this.

A B
says
10 January 2020 at 1:54 am

My husband of 20 plus years has not been diagnosed with dementia. I have been considering seeking a diagnosis. As joint owners of a business in which he has been the intellectual force our small team is suffering from his diminishing skills but lacl of recognition of the fact. From reading all of the comments it seems there is no point In seeking a diagnosis. Continuing with my practical plans to extracate us both and retire at whatever cost seems to be my only solution in hope that removing the stress as he is unable to complete projects, in the field in which he is a respected expert, become beyond him. I am sad to hear that there is so little assistance we are in our 60s, this could be a long and lonely journey.